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Risk factors for severe sepsis in community-onset bacteraemic urinary tract infection: impact of antimicrobial resistance in a large hospitalised cohort.
Shaw, Evelyn; Benito, Natividad; Rodríguez-Baño, Jesús; Padilla, Belén; Pintado, Vicente; Calbo, Esther; Pallarés, M Angeles; Gozalo, Mónica; Ruiz-Garbajosa, Patricia; Horcajada, Juan Pablo.
Afiliação
  • Shaw E; Servicio de Enfermedades Infecciosas, Hospital Universitari de Bellvitge - IDIBELL, Barcelona, Spain. Electronic address: eshawp@gmail.com.
  • Benito N; Servicio de Enfermedades Infecciosas, Hospital de Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Barcelona, Spain.
  • Rodríguez-Baño J; Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Departamento de Medicina, Universidad de Sevilla, Sevilla, Spain.
  • Padilla B; Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital Gregorio Marañón, Madrid, Spain.
  • Pintado V; Servicio de Enfermedades Infecciosas, Hospital Ramón y Cajal, Madrid, Spain.
  • Calbo E; Servicio de Medicina Interna, Hospital Mútua de Terrassa, Barcelona, Spain.
  • Pallarés MA; Servicio de Microbiología, Complexo Hospitalario de Pontevedra, Spain.
  • Gozalo M; Servicio de Microbiología, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
  • Ruiz-Garbajosa P; Servicio de Microbiología, Hospital Ramón y Cajal, Madrid, Spain.
  • Horcajada JP; Servicio de Enfermedades Infecciosas, Hospital Universitari del Mar and Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
J Infect ; 70(3): 247-54, 2015 Mar.
Article em En | MEDLINE | ID: mdl-25305497
OBJECTIVE: To determine risks factors associated with severe sepsis or septic shock (SS) at admission in patients with community-onset bacteraemic urinary tract infection (CO-BUTI) including the impact of multidrug-resistant (MDR) bacteria. METHODS: We analysed a prospective cohort of all consecutive episodes of CO-BUTI requiring hospitalisation in 8 tertiary hospitals of Spain between October 2010 and June 2011. RESULTS: Of an overall of 525 CO-BUTI episodes, 175 (33%) presented with SS at admission. MDR bacteria were isolated in 29% (51/175) of episodes with SS and in 33% (117/350) of those without SS (p = 0.32). The main MDR microorganism was Escherichia coli in both groups (25% and 28% respectively). Independent risk factors associated with SS at admission were: having fatal underlying conditions, McCabe score II/III (OR 1.90; 95%CI 1.23-2.92; p = 0.004), presence of an indwelling urethral catheter (OR 3.01; 95%CI 1.50-6.03; p = 0.002) and a history of urinary tract obstruction (OR 1.56; 95%CI 1.03-2.34; p = 0.03). After considering interactions, indwelling urethral catheters were a risk factor only for patients without fatal underlying conditions. CONCLUSIONS: SS at hospital admission occurred in a third of CO-BUTI. Mainly host factors, and not the causative microorganisms or antimicrobial resistance patterns had an impact on the presence of SS.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Choque Séptico / Infecções Urinárias / Bacteriemia / Sepse / Farmacorresistência Bacteriana Múltipla / Infecções por Escherichia coli Idioma: En Ano de publicação: 2015 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Choque Séptico / Infecções Urinárias / Bacteriemia / Sepse / Farmacorresistência Bacteriana Múltipla / Infecções por Escherichia coli Idioma: En Ano de publicação: 2015 Tipo de documento: Article